956 (2) Lor NO. 10
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L14V5 R APPLIANCE PERMIT
IOCT 1 1962 OF CUPERTINO
Date 9 2 V 162 �vfG 196..... Permit No. 9 S� _
. TINO Fees I cc
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Application is hereby made to the City of Cupertino for a permit to install
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gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode offthe City
of Cupertino, and all other laws applicable thereto.
UseofPremises Res.
OwnerCamino Del Homes _ AddressP C_Soa-_6_3v
Cupertino
By o ,_ � '� Addrcss
.,o CONTRACTOR, AGENT i. I
Phone 'Approved
PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance I Units Fees.II New Replace Relocate
Gas Ranges "11
Wall Heaters
Gas Plates
Circulating Heaters I
Blower Furnaces yf�'1�1�fY
Gas Fired Boilers 1 41 _
Warming Ovens .��
Percolators
Griddles
Steam Ta les
.Gravity Furnaces
Suspended Unit JII'
Floor Furnace*
l Miscellaneous
NAME TYPE
?.*de1,MIa
ISO� IAaiI� _
IF
pp lance Fees t' y
Inspected and Approved -�� -
DATE. INSPECTOR
y.
OFFICE
COPY
AS, SERVICE NOTICE
UILDJNG INSPECTOR'S OFFICE
CITY-OF CUPL'RTINO
To ----- --- ................ .....1196-- -----
You are hereby au i dic,connect the GAS c or
Owner or Tenant -- --- ----- --
-- -- ------- -------- -- ......
At -----/l)31R.'...... ........ ------AW-------
New Service ...._---------------
No. of.Meter, ------- Reconnect ----- ............ ...........
Move Service ------------------
No. of Add. Meters -------- Move Meter .......*
P,
. ......... ------
nLWBLNq-INSPECTOR
110 7/61-500